Effects of Macular Changes on Visual Acuity Observed During Fundus Fluorescein Angiography in Patients with Type-II Diabetes Mellitus - A Prospective Observational Study

Abstract Aim: A Prospective observational study investigating the Association between angiographic macular changes and visual acuity in patients with Diabetic Retinopathy, using Fundus Fluorescein Angiography (FFA). Introduction: Diabetic Macular Edema (DME) remains one of the commonest ocular complications of DM affecting individuals in their most productive years of life. This study aims to find the Association between Foveal Avascular Zone (FAZ) abnormalities with staging of DR and its impact on Best Corrected Visual acuity (BCVA) using FFA. Materials and Methods: FFA based Prospective Observational Study among patients with type-II DM with DR, conducted in the Department of Ophthalmology, in a tertiary care hospital in South India from October 2019 to April 2021. Written informed consent obtained, BCVA documented, DR and DME were classified based on ETDRS grading. FFA performed and images analysed by single experienced clinician and number of microaneurysms, Capillary non-perfusing units (CNP) and regularity of FAZ documented. Results: One hundred seventy-one eyes of 156 patients were included, of which 21 eyes had (12.3%) FAZ distortion. There was a significant association between grading of maculopathy and frequency of microaneurysms within One Disc Diameter (1DD) from foveal centre, for moderate and severe maculopathy group with P value = 0.00001. There was a significant association between BCVA and CNP areas outside major arcade ( P value 0.003). There was a significant association between FAZ distortion and BCVA with P value of 0.005. Conclusion: FFA still remains the gold standard investigation of choice for detecting ischemic maculopathy and guiding the precise use of laser therapy to preserve vision especially in young diabetics.